MARK CARROLL EDDY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

ACTIVE

Business

First Name

MARK

Middle

CARROLL

Last Name

EDDY

Suffix

Business Name

MARK CARROLL EDDY MD

Original Issue Date

08/13/2008

Effective Date

06/03/2023

Expiration Date

07/31/2026

City

ST LOUIS

State

Zip

63119

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2023